宫颈环状电切术和宫颈冷刀锥切术治疗CINIII患者的对比研究.docVIP

宫颈环状电切术和宫颈冷刀锥切术治疗CINIII患者的对比研究 甘肃省妇幼保健院 宫颈病变中心 吴珍珍 许晓英 穆荣肖 730050 【摘要】目的 比较宫颈环状电切术(1oop electrosurgical excision procedure，LEEP)和宫颈冷刀锥切术(cold-knife conization，CKC)的疗效及对患者生活质量的影响。 方法 对我院2006年宫颈病变门诊收治的CINIII患者，依据其志愿采取LEEP或CKC治疗并追踪随访，评价两种术式。 结果 两种术式的术后并发症发生率LEEP手术组为5.80%，CKC组为5.26%）；治愈率差异无统计学意义（LEEP手术组为95.65%，CKC组为98.25%）；生活质量方面LEEP手术组优于CKC组，术后SF-36生活质量评分差异有统计学意义，（P0.05）。结论 对于CINIII患者，LEEP手术组与CKC组治愈率及主要不良事件的发生率没有显著差异；成本分析显示，LEEP术具有不住院、花费少的特点；SF-36生活质量评分证实在生活质量方面LEEP组优于CKC组，差异有统计学意义，表明LEEP术是处理CINIII的常用和理想的治疗方法。 【关键词】宫颈上皮内瘤变 宫颈环状电切术 宫颈冷刀锥切术 对比研究 Loop electrosurgical excision procedure versus Cold-knife conization for Cervical Intraepithelial Neoplasia Ⅲ 【Abstract】 Objective In an open-label, randomized trial ,our aim is to compare the safety and benefits of 1oop electrosurgical excision procedure(LEEP) with that of cold-knife conization(CKC). Methods In 2006,a total of one hundred and twenty-six patients were enrolled and followed by either LEEP or CKC who were diagnosed with cervical intraepithelial neoplasia Ⅲ(CIN Ⅲ). Results The cure rate was similar in both groups(95.65% versus 98.25% in LEEP and CKC).The overall complication rate was similar in both groups (5.80% versus 5.26% in LEEP and CKC).Physical function and physical health scores on the short-form 36 (SF36) quality of life assessment forms were better in the LEEP group（P﹥0.05）. Conclusion The cure rate and the overall complication rate was similar in both groups．But the LEEP did offer an advantage over the CKC in quality of life scores. 　 【Key words】cervical intraepithelial neoplasia 1oop electrosurgical excision procedure cold-knife conization study 宫颈癌是全球妇女中仅次于乳腺癌的恶性肿瘤，位居女性生殖器官癌肿之首。研究表明[1]，部分宫颈上皮内瘤变(Cervical Intraepithelial Neoplasia，CIN)可逐渐进展成为宫颈浸润癌，因此早期发现宫颈癌前病变并对其进行干预治疗是预防宫颈癌的有效途径。近年，宫颈上皮内瘤变的发病率不断升高，患者年龄也日趋年轻化。因此，对年轻患者选择合适的术式，既达到治疗效果，又不影响患者的生活质量尤为关键。目前CINIII常用治疗方式有激光、LEEP和冷刀锥切、子宫全切等［2］。对早期病变治疗手段的选择和预后的评价逐渐引起人们的重视。宫颈环状电切术(1oop electrosurgical excision procedure，LEEP)和宫颈冷刀锥切术(cold-k